Recently I saw a number of outpatient respiratory patients and was only given half an hour to see each of them. I managed my time well, up until my last patient of the morning. This elderly man with COPD obviously had no idea bout two way communication and his dyspnoea definately didn't curb his talking. As he walked in he asked me and my supervisor a question. He said; Three things happen on the 25th April, what are they? I replied with ANZAC day but that was all I could think of. He went on to tell me that I was correct and then to say that the other things are that the baby herring migrate from South Australia, up the WA coast line and something else about olive trees. Unfortunately he wasn't so concise though, taking about fifteen minutes to complete that story. He also went on to inform us on a lot of other subjects and share his childhood memories with us. As if we weren't enjoying his company enough, he started to serenade my supervisor which is when he started turning from a sweet old man to someone who struck us as a little creepy.
The issue that I had however, is that a thirty minute session turned into an hour long session and I struggled to get any information out of this patient at all as every time I asked him something, he turned it into another story. This was starting to anger me a little as I wanted to help this patient but needed his co-operation to do so. I tried to interrupt a few times and I even explained that we didn't have a lot of time but nothing seemed to work. Even at the end of the session, he would not stop talking. I stood up in an attempt to end the session and when that didn't work I walked to the door and opened it. To my amazement, he still didn't stop. Finally I had to tell him that I was sorry but I had to ask him to leave so I could see the other patients.
As you can see I tried many ways to communicate successfully with this patient but nothing I could do seemed to work. I am wondering if anyone else has experienced a similar situation and had any ideas for how to deal with these sort of patients in the future.
In future I think I will identify these sorts of patients earlier and take charge of the conversation with more closed questions.
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Sounds like a very tough pt Adam. From what you said you did everything you thought of and I beleive everyone probably would of done exactly the same thing because as students we havent had as much experience with as many patients as supervisors and senior PTs and so we kind of think that cutting someone off mid conversation is rude and in doing so sometimes compromise our treatment session.
I think maybe next time when you realise that it is that sort of patient you have to do as you said and really take charge of the conversation and the questions you are asking and ensure they dont get off track. If they do continue to stray maybe you have to be a bit rude in order to get them back doing what you want.
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